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Topic: Latissimus Dorsi Flap Surgery and Horse Back Riding

Forum: Surgery - Before, During, and After — Surgical options and helpful tips for recovery and side effects.

Posted on: Apr 30, 2010 06:24PM

cowgal wrote:

I had a mastecomy on March 31 and after radiation plan to do latissimus dorsi flap surgery.  My plastic surgeon ruled out the tram flap surgery because of my active lifestyle (lifting feed sacks, riding, etc.).  He felt the latissimus dorsi flap surgery would be better suited for me (I don't want to do the regular implant surgery) and that it would not make it any harder for me to ride.  I was reading "The Breast Cancer Survivor's Fitness Plan" and it states some of the challenges with this kind of surgery and it listed "climbing a ladder".  I am not sure but think that this would involve the same muscles as riding a horse.  I just wondered if any horse riders out there have done the latissimus dorsi flap surgery and if so if they have any problems getting mounted because of this or any other problems for that matter?  Thanks!

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Apr 30, 2010 07:24PM NotAgain2015 wrote:

Hi cowgal, 

I'm somewhat new here and just diagnosed with DCIS this week w/ a ton of family history.  Trying to decide what to do.  Part of me thinks there could be a PBM in my future.  I also ride and had no idea it could affect my passion in life too!  I look forward to hearing from others who ride.  I hope you are feeling well.  Thanks for sharing your experience.  Keep us posted if you can - I look forward to hearing how you are doing.

Dx 4/23/2010, DCIS, Left, <1cm, Stage 0, Grade 2, ER+, HER2- Dx 2/17/2011, IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 10/30/2015, IDC, Left, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 12/16/2015 Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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May 2, 2010 10:26AM - edited May 2, 2010 10:27AM by cowgal

Hi Kickon2it,

I'm fairly new on here as well.  I was diagnosed on March 2 and then had the mastectomy on the 31st and they put an expander in at that time.  I have IDC and have zero family history so they did the genetic test on me just because they recommend it if you have cancer at 45 or younger.  I tested negative.  What does "PBM" stand for (I can't find where they show abreviations on this site)?  Honestly, I get tired easier, I've lost some strength and I do have some discomfort (from my mastecomy and expander) but every day I make more progress.

 I do have some other resources that I can contact to try to help get information on any challenges breast cancer surgeries, etc. will pose for riding long term and let you know.  As I'm getting ready to start radiation in a month or so and not sure how tired or if the burning will slow me down, I'm thinking that I may take this time to try to teach my horse (he's pretty tall for a stock horse) how to either sit or lay down so that I can get on him just in case there is a problem later on. 

Keep me posted on your experience and I hope you are doing well and keeping a positive attitude.  I think it really helps to have the attitude that your battle plan for getting through breast cancer is to not merely survive it but to thrive through it. 

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May 4, 2010 11:11PM NotAgain2015 wrote:

I need to lookup acronyms before I use them!  By PBM I meant prophylactic bilateral mastectomy. 

I'm glad to hear you are doing well.  Sorry that you are tired and sore, but good that you feel better every day.  I sent my horse to a friend to ride for a couple of weeks to keep him going while I just had my surgery.  I'm hoping that radiation treatments will go ok and that I can still ride during that time.  I've got to keep my sanity!  I love the sit or lay down idea!  That would be a challenge for me.  If you get yours to do that - you have to send me a picture!  I love natural horsemanship and have some Clinton Anderson-style basics on my 16.3 gelding.

Isn't it nice to think about horses instead of breasts even if it is just for 5 minutes?  :)

I am in that fact gathering stage - I'm also going to get that genetic test because of my family history.  I'm concerned about radiation to my left breast, etc.  Then I wonder if I will be brave enough to actually have a double mast if I find out I have the marker.  I'm astounded every day as I read these boards and hear the words of all of you brave women who have been through this.

I like your last paragraph - I'm in that I feel like i've been kicked in the gut stage.  I need to shake it off, get up and get going with my battle plan.

Stay in touch...

Dx 4/23/2010, DCIS, Left, <1cm, Stage 0, Grade 2, ER+, HER2- Dx 2/17/2011, IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 10/30/2015, IDC, Left, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 12/16/2015 Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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May 8, 2010 02:23AM SandyinSoCal wrote:

If you have an active lifestyle, you might want to research flap reconstruction options which don't require the sacrifice of core muscles, including the lats. The latissimus dorsi is the most powerful muscle of the back and is the bridge between the lower back and the neck.  They are critical for maintaining good posture, for climbing, rowing, and they aid our breathing.  Lats are used in swimming, especially in the down stroke of a crawl.  Reconstruction using the lats or rectus muscles (TRAM) are outdated, as there are several newer options for flap reconstructions that do not remove any muscle at all.  Please investigate DIEP, GAP and hip flaps, all of which will preserve your muscle function and give you soft, warm breasts made of your own tissue.   The NOLA docs (www.breastcenter.com) are known for their ability to do tissue flap reconstruction on even very athletic women, including those who've been told by other less experienced surgeons that they don't have enough fat.  You owe it to yourself to receive state of the art breast reconstruction using the latest techniques, so do your research before submitting yourself to a procedure that can cause you functional difficulties for the rest of your life.
I am wonderfully made to do ExtraOrdinary things! (www.girleo.com) Dx 5/22/2007, IDC, <1cm, Stage I, Grade 3, 0/1 nodes, ER+/PR+, HER2-
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May 8, 2010 02:37AM Minnesota wrote:

I saw the name of your thread and wondered why you'd be considering this surgery, especially if you ride horses. I haven't ridden in years but used to ride a lot. I can imagine many ways that loss of this muscle could impact you. In addition to mounting, I think it could impact your reining ability, and perhaps your seat. I agree with the poster above that you should investigate other flap techniques that may be beyond those your local plastic surgeon offers.

(Pleomorphic LCIS) Dx 5/2006, LCIS, 4cm, Stage 0, 0/1 nodes, ER+/PR+, HER2-
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May 8, 2010 06:18AM Shrek4 wrote:

Cowgal,

With your life style, LD flap is a definite no. I have an active life style,  but by no means as active as yours, and I am 6 months after the surgery and still quite severely disabled.Find a doctorwho can do DIEP, GAP or hip flaps, dont' do like me and believe your PS saying that it won't affect you much. Lifting, mounting, reining, even sitting for prologed periods of time will be if not impossible (they will be impossible int he beginning)then very very hard to do. It takes close to 2 years to get all yoru range of movement after this procedure, and you will still not be able to do several moves.

Please reconsider, and try to find another PS who can do one of the above-mentioned recons.

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May 8, 2010 11:00AM cowgal wrote:

Thanks SandyinParadise, Minnesota and Day for your posts.  I will check into some of these other options.  I really appreciate your help.

Kickon2it, I like Clinton Anderson's training too and use a lot of his, John Lyons, and Al Dunning's training ideas.  I think I have a willing horse to learn tricks but I have decided that it may be too hard on a horse to have to raise back up with a rider on and still trying to think of something that will make him easier to mount for me and still be easy on him. 

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May 12, 2010 12:55AM Diane509 wrote:

I just had lat flap dorsi..... my ps assures me I will still be able to play tennis, swing a golf club and ride my horse.  Just had the surgery yesterday so right now it all seems quite impossible, but I trust him.  My lat flap has no back scar, maybe that is why.  Surgeon in Spokane WA has a special technique.

Good luck all.... my drains hurt...... but they will be gone in a few weeks time.

Diane 

Dx 2/17/2010, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+
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May 12, 2010 12:56AM Diane509 wrote:

Cool
Dx 2/17/2010, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+
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May 12, 2010 01:23AM MelG wrote:

Hi Cowgal, I had a lat dorsi reconstruction in 2005 1.5 years after mastectomy and chestwall radiotherapy.  If it wasn't for the scar on my back, (and the boob on my front lol) I wouldn't even know I'd had it.   I can do everything I did before.   Haven't ridden a horse, but have scuba dived, and I can shimmy up and down a ladder like nobody's business.   I can't quite manage the bench press at the gym but that seems to be more the discomfort from the front part of the reconstruction when I try and lift weights lying on my back. 

Good luck with whatever you decide!

Luv Mel

Dx 7/2003 IDC 7.5cm, 1/11 nodes, ER/PR+ Stage 3(a) Dx 7/15/2003, IDC, 6cm+, Stage IIIA, Grade 1, 1/11 nodes, ER+/PR+
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May 12, 2010 02:44AM CalypsoGirl wrote:

Hi Cowgirls! 

Back in 2002 I had a mx with free tram flap on my left side and I've been riding ever since.  I was extremely please with the result (nice & soft, just your own body tissue).  No abdominal weakness either!  Then, in May of 2008 I found a lump in my right breast (during those 5 years, they told me "don't worry your pretty little head!")...  So there I was back to square one... I had a mx June 2008, 6 months of chemo, 5 weeks radiation, got my ovaries pulled last November, and finally on April 1st I had the lat flap with TE.  I rode my gelding a little on Mother's Day (even though I am still sore).  I'll admit that it is all pretty rough, however right now filling the expander every 10 days is extremely painful (my fun meter is pegged).  On the other hand, with the tram flap the first 4 weeks were tough, but recovery was a steady improvement.

My PS did not recommend the GAP flap because it may expose the sciatic nerve (your buttocks is critical when riding!).

 If I could go back in time to Oct. 2002, I would have pushed to have both breast removed at the same time... Better symmetry... They didn't even automatically do genetic testing back then!  I was 38... Water under the bridge...

I use Clinton Anderson's method with my two horses  Laughing  It's great to see them using the thinking side of their brain!!  My horses are my best therapy!

Hope this info helps!  Take care & let us know how you are doing!

Kathy - my very first post!

Dx 5/18/2008, IDC, 1cm, Stage IIB, Grade 2, 1/11 nodes, ER+/PR+, HER2-
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Jun 10, 2010 02:13PM Diane509 wrote:

I went to see my horse yesterday after 1 month... poor baby.  I gave him his de-wormer and his 5 way but it nearly killed me trying to put his halter on...... he is only 14.2 hands too....(uncooperative in dropping the head... payback for not coming around!)  He's in a small run... I know he needs some exercise but I just can't do it yet.... maybe next week I can get him into a round pen.  Even brushing hurts... darn it.

Dx 2/17/2010, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+
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Jun 13, 2010 05:25PM NotAgain2015 wrote:

Hi Mel, Kathy and Diane,

Its great to hear from other riders.  I'm getting ready to start radiation this week (gulp).  Had contemplated double mastectomy.  Hope I won't be kicking myself on down the road.   Calypso, sorry you are going through round 2.   Diane, hope you are getting stronger every day.  Let's keep in touch.

Dx 4/23/2010, DCIS, Left, <1cm, Stage 0, Grade 2, ER+, HER2- Dx 2/17/2011, IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 10/30/2015, IDC, Left, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 12/16/2015 Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Aug 24, 2010 12:57AM Diane509 wrote:

Hi ladies... I am still not riding.... going through PT to regain range of motion.  Still waiting for last fill and exchange in 3 months... and the horse if for sale...

Dx 2/17/2010, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+
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Aug 24, 2010 03:48PM NotAgain2015 wrote:

Hi Diane,

Sorry to hear you have your horse up for sale.  I know that's hard.  I don't know who I am without a horse, so that would be devastating to me.  I hope you are doing ok.

Sounds like you are working to get your range of motion back.  Three months will fly by and hopefully you'll be back to the new normal by then.

I finished radiation treatments two weeks ago and I am finally starting to feel normal again.  Next contemplating tamoxifen.  That's the upside of what you have chosen, you don't have to take it!  I'm envious!

Hang in there...

Dx 4/23/2010, DCIS, Left, <1cm, Stage 0, Grade 2, ER+, HER2- Dx 2/17/2011, IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 10/30/2015, IDC, Left, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 12/16/2015 Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Sep 25, 2010 01:20AM Diane509 wrote:

Hi Kick...

I have not been regularly on the boards lately, thanks for the condolences about the horse.  I went to see him today and he acted really happy to see me.  I put him in the round pen and he didn't even roll or kick up his heels or toss his head like he normally does.  I wonder if someone has been riding him.  I told the guy at the barn that I was interested in selling him, but after today... I got pretty sad at the thought.  I probably could ride again if I got my confidence back and started riding a few times a week.  Grooming him today was good for my muscles actually.  Im still afraid to hoist up something heavy like a saddle or if he decides to yank his head and tug ... I cringe at the thought of getting pulled apart!Charely Horse

Dx 2/17/2010, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+
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Sep 26, 2010 02:49PM NotAgain2015 wrote:

Hi Diane,

What a nice looking horse.  He looks just like Black Beauty :).  I'm glad you went out to see him.  If you are like me, there's just something about looking at your horse - what it does for your heart and soul.  Even if it is just being around the wonderful smells of the tack room, your horse and barn in general.  There was an article in a horse magazine issue recently.  I'm going to see if I can find it.  It was inspirational about another BC survivor.  I'll post it here if I can find the link.

Any chance to find a person who could half board him with you and ride him?  Someone you trust...   Then you'd know he has the edge off.  Can you take lessons or have someone there spotting you so to speak?  I know exactly what you mean about getting your confidence back - my horse is young and I'm now over 50 and not as brave as I used to be.  If I can figure out how to post a picture I'll share one of my pony too.

Dx 4/23/2010, DCIS, Left, <1cm, Stage 0, Grade 2, ER+, HER2- Dx 2/17/2011, IDC, Right, <1cm, Stage IA, Grade 2, 0/2 nodes, ER+/PR+, HER2- Dx 10/30/2015, IDC, Left, 1cm, Stage IA, Grade 2, ER+/PR+, HER2- Surgery 12/16/2015 Mastectomy: Left, Right; Reconstruction (left): DIEP flap; Reconstruction (right): DIEP flap
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Oct 23, 2010 11:11AM Diane509 wrote:

Rode my horse again yesterday ...  it was fun but I am even more nervous on him than i was before my surgery.   We have to relearn our communication.  He is well broke but takes advantage of my lack of experience when we ride.  

Dx 2/17/2010, DCIS, 1cm, Stage 0, Grade 2, ER+/PR+
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Apr 2, 2011 05:43PM - edited Apr 2, 2011 06:47PM by virg


I am not sure if this thread is still active, but just in case... I chose lat flap reconstruction and though I don't know the roads not taken, from where i am now, it seems I made a mistake.  It was a comfort, I believe, to wake up from the mastectomy and look down and not be minus a breast, only minus a nipple, but there have been side effects.  The side effects have not been life threatening.  The complications / side effects have been how it feels, the discomfort.  What concerns me is that if others have had the experience I have had and everyone seems to agree that exercise can save the life of people with a BC diagnosis, we are going to lose people.  Exercise aggravates my breast, arm, armpit and back.  There is pain, discomfort and fluid build-up after Yoga and any aerobic exercise.  It is not debilitating but can be very uncomfortable.  I do not have "lymphedema" if lymphedema is only defined as a condition that will always require a sleeve and the care of a lymphedema specialist.  I know that fluid builds up and I know that with self-care I can affect the discomfort.   I would be interested in hearing from others how their arm and the area affected by the surgery feels and what helps.  My surgeon said, when I asked about swimming, "...you won't be competing in the Olympics."  In hindsight, I wish I had hung in there for a better conversation and a more sensitive answer.  My swimming has been affected.  I should say, though, that I was able to ride just fine for a week last year.  I rode hard for a week and I hadn't ridden in many years – pure joy!    I wanted to add, this last time when a failed implant was replaced, the surgeon used staples.  I can feel em and they are uncomfortable....has anyone else had experience with staples. The surgery was at the end of the year, so maybe this will pass.  Also, does anyone have any thoughts about the NYT articles on implants and cancer?  My surgeon said there are only 2 companies that make implants and only one company is making the implants that are the problem.  As I said, given the choice, knowing what I know now, I would choose a flat chest and no foreign bodies in my body.  But years from now and with that perspective...could feel different again. 

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